Psychological predictors of the antihypertensive effects of music-guided slow breathing.

Author: Modesti PA, Ferrari A, Bazzini C, Costanzo G, Simonetti I, Taddei S, Biggeri A, Parati G, Gensini GF, Sirigatti S.
aClinica Medica Generale e Cardiologia, Department of Critical Care Medicine, University of Florence, Italy bFondazione Don Carlo Gnocchi Onlus IRCCS Centro S. Maria agli Ulivi, Pozzolatico, Italy cDepartment of Psychology, University of Florence, Italy dDepartment of Statistics, University of Florence and ISPO Cancer Prevention and Research Institute, Florence, Italy eDepartment of Clinical Medicine and Prevention, University of Milano-Bicocca, Italy fDepartment of Cardiology, S Luca Hospital, Istituto Auxologico Italiano, Milan, Italy.
Conference/Journal: J Hypertens.
Date published: 2010 Feb 12
Other: Word Count: 255

BACKGROUND: The possibility that daily sessions of music-guided slow breathing may reduce 24-h ambulatory blood pressure (ABP), and predictors of efficacy were explored in a randomized, placebo-controlled trial with parallel design. METHODS: Age-matched and sex-matched hypertensive patients were randomized to music-guided slow breathing exercises (4-6 breaths/min; 1: 2 ratio of inspiration: expiration duration) (Intervention; n = 29) or to control groups who were thought to relax while either listening to slow music (Control-M; n = 26) or reading a book (Control-R; n = 31). At baseline and at follow-up visits (1 week and 1, 3 and 6 months), ABP monitoring was performed. RESULTS: At mixed model analysis, intervention was associated with a significant reduction of 24-h (P = 0.001) and night-time (0100-0600 h) (P < 0.0001) systolic ABP. The average reduction of systolic 24-h ABP at 6 months was 4.6 mmHg [confidence limits at 95% 1.93-7.35] and 4.1 mmHg (95% confidence limits 1.59-6.67) vs. Control-M and Control-R groups, respectively, (P < 0.001 for both). Antihypertensive treatment was selected as negative predictor of BP reduction at multivariate stepwise analysis. When antihypertensive treatment was inserted as covariate in a generalized linear model, psychological subscales assessed at baseline by the Mental Health Inventory questionnaire were found to affect systolic blood pressure reduction at 6-month follow-up (general positive affect P < 0.001; emotional ties, P < 0.001; loss of behavioral control, P = 0.035). In particular, a level of general positive affect higher than the 75th percentiles was found to be significantly associated with low treatment efficacy (odds ratio 0.09; 95% confidence limits 0.01-0.93). CONCLUSION: Daily sessions of voluntary music-guided slow breathing significantly reduce 24-h systolic ABP, and psychological predictors of efficacy can be identified.